Childhood stroke: A prospective study on risk factors, clinical profile, and short-term outcome in a tertiary care hospital in Eastern India

Abstract

Background: Childhood stroke is an acute onset neurological sign or symptom attributable to focal brain infarction or haemorrhage. It is an under-studied entity and is scarcely reported from India.Objectives: To evaluate the risk factors, clinical profile and short-term outcome (after a 6-month follow-up) of childhood stroke in a tertiary care hospital of Eastern India.Method: This observational, prospective study was conducted on 50 patients aged 2 months to 12 years over a period of 18 months. Data on history, examination, relevant investigations, radio-imaging and follow-up was taken and recorded on a pre-formed proforma and analysed.Results: Out of the 50 cases, 23 (46%) had arterial ischaemic stroke (AIS), 12 (24%) had cerebral sino-venous thrombosis (CSVT) and 15 (30%) had haemorrhagic stroke (HS). The common risk factors were infection (30%) and vascular disorder (24%), including arteriopathy and vascular malformation. Common presentations were seizures (78%) and hemiparesis (70%). Eight (16%) cases died. Although none died among AIS and CSVT cases, there was statistically significant mortality in HS (p<0.001). After 6-month follow-up of discharged cases (n=42), partial neurological recovery was noted in 64.3%.Conclusions:  AIS was the most common type of stroke. Commonest risk factor was infection and commonest presentation was seizure. Mortality was observed only in HS. Majority achieved partial neurological recovery on short-term follow-up.